Chris Allen Clark, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

039072 Issued in GA

Practice address

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129

Phone

(770) 382-1530

Fax

(770) 387-8198

NPI assigned

Mar 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1689634362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOE FRANK HARRIS PKWY SE",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202129",
            "telephone_number": "770-382-1530",
            "fax_number": "770-387-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRIS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "039072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Choate Dental Assoc PC
• Brian Jackson Choate, D.M.D.
• Zimri Jackson Choate, DDS
• Eunis Choi, D.M.D.
• Ryan Michael Christie, M.D.
• Savanna Clark, BCBA
• Renee Clarke-Hall, ACNP
• Madlyn Clawson
• Ashunte Denise Claybrooks, LPC
• Kathryn Head Claytor, FNP-C

• Anatomic Pathology & Clinical Pathology Physician in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.